Pituitary-Adrenocortical Studies in a Patient with Cushing's Syndrome Induced by Thymoma1

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Abstract
A 28-yr-old male with Cushing's syndrome induced by an ACTH-like substance secreting thymoma is reported. Remission of the disease followed the successful removal of the tumor and no sign of Cushing's syndrome was observed 2 yr after surgery. ACTH activity was demonstrated in the extracts of the thymoma, but no increment in the urinary ACTH was observed. Pigmentation and hypokalemia were slight and no metabolic alkalosis was detected. The results of studies of pituitary and adrenocortical function in this case were consistent with those in 10 cases of Cushing's syndrome due to adrenocortical hyperplasia. This case was unusual in that a definite response was observed both to large doses of dexamethasone and to metyrapone. It was postulated that the secretion of the ACTH-like substance of the tumor was not entirely autonomous.